HomeMy WebLinkAbout207543 03/26/2012 CITY OF CARMEL, INDIANA VENDOR: 204038 Page 1 of 1
ONE CIVIC SQUARE MIDWEST TOXICOLOGY SVS,INC
o CARMEL, INDIANA 46032 603 E WASHINGTON ST SUITE 200 CHECK AMOUNT: $165.00
INDIANAPOLIS IN 46204 CHECK NUMBER: 207543
CHECK DATE: 3/26/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 R4358800 26423 262361 165.00 TESTING FEES
Midwest Toxicofogy Invo
Q F Services, Inc.
DATE INVOICE
4
603 East Washington Street, Suite 200, Indianapolis, IN 46204 3/15/2012 262361
BILL TO: SHIP TO:
City of Carmel Names location of collection
Attn: Jim Spelbring on invoices no ss
1 Civic Square Email results to Barb Lamb cc Jim
Carmel, IN 46032 Still Mail results to Jim
KK
CONTROL P.O. NUMBER JOB SITE TERMS FACILITY
5528 Due on receipt 142376
ITEM CODE QTY DESCRIPTION PRICE EACH CLASS AMOUNT
ND Drug Test... 3 Non -DOT Drug Test 55.00 Indiana 165.00
Collected at Community Occ. Health Center
(MedCheck) Carmel
03/07/12
Shalina Harrington
03/09/12
Stacy Mattox
03/12/12
Andrew Smith
D Q
MAR 2 6 2012
By
A finance charge will be assessed all invoic not id in 30 pays. Thank you for your business.
d ank you r for your Dustness. Total $165.00
Make Checks Payable To: MIDWEST TOXICOLOGY SERVICES, INC.
For questions regarding this invoice, contact us at 317 -262 -2200 or fax us at 317- 262 -2222.
Be sure to visit our website at www.ntidwesttoxicology.cont.
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date N umbe r (or note attached invoice(s) or bill(s))
03/15/12 262361 $165.00
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
1 20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Midwest Toxicology
IN SUM OF
603 East Washington Street, Suite 200
Indianapolis, IN 46204
$165.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
26423 I 262361 I 43- 588.00 I $165.00 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Thursday, March 22, 2012
Director, H
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund